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Comagine Health

Careers

Director, Care Management Services




Category

Care Management

Job Location

Baltimore

Tracking Code

2022-123

Industry

Health Care

Job Level

Management

Position Type

Full-Time/Regular

Years of Experience

10+ to 15 Years

Comagine Health is looking for experienced, senior-level health care professionals to lead our Maryland care management services teams. We provide utilization review, care coordination and quality management services for Medicaid programs including hospital, outpatient, long term care, behavioral health and home and community-based services. We consult on public health initiatives, develop and deliver healthcare delivery improvement projects, and support clinical care management programs.

 

If you have leadership experience leading utilization management, care coordination and/or quality management programs, we’d like to chat with you about this job. Which brings us to why you might like to chat with us. Let’s start with:

 

Who is Comagine Health?

 

Comagine Health is a mission driven, non-profit health services organization that works to improve health and create a better health care system so people and communities flourish . We support providers, plans, purchasers, and consumers, and offer services to state and federal agencies and others to help them better manage health care under the existing system and to assess, plan for and implement broader system transformation. Our Care Management Division works closely with state Medicaid and workers compensation agencies to provide compassionate, evidence-based care management services.

We are committed to ensuring individuals receive the care they need at the right time and in the right setting.

 

Typical Job Duties

In this role, you would direct and oversee all aspects of assigned contract(s) to ensure fulfillment of all deliverables, retention of existing business, and potentially new business. Typical accountabilities include:

  • Manage clinical and non-clinical staff who provide medical management services.
  • Develop and maintain departmental policies and procedures, staffing protocols, training programs, quality improvement / management programs, and budgets.
  • Ensure that department meets all required legal, contractual, and accreditation standards and compliance with corporate policies; provide subject matter expertise on contractual provisions and relevant regulations.
  • Act as primary liaison between Comagine Health and the client, providers, and other stakeholders.
  • Contribute to community outreach, provider relations, business development, and related activities.

These positions will work remotely, but have occasional, periodic on-site duties in Owings Mills , MD with internal and external partners. Candidates will need to reside within a commutable distance.

 

Please note that this position is contingent on contract award, and is expected to start in November or December of 2022.


Required Skills

  • Intermediate MS Office Suite proficiency
  • Strong knowledge of Medicaid or commercial insurance utilization and quality control
  • Familiarity with InterQual or other clinical decision support
  • Familiarity with at least one medical management application (e.g., Jiva) preferred

Required Experience

  • 7+ years of medical management experience
  • 5+ years of supervisory / management experience, including financial management
  • BA / BS in a related field
  • MA / MS in a related field preferred
  • Current, active, unrestricted licensure in Nursing (RN) or Behavioral Health (Clinical Social Worker, Professional Counselor, Marriage & Family Therapist, Psychologist) preferred
  • Certification in a related medical management specialty preferred

 

Salary Range: $100,000-$140,000

The salary range posted reflects the range that Comagine is willing to pay for this position.  Salary is determined by many factors, including but not limited to geographic location of where the employee will perform their job duties in addition to their knowledge, skills, education, and relevant work experience.

 

Please note that this position is contingent on contract award, and is expected to start in November or December of 2022.

 

 

As a federal contractor, and in compliance with Executive Order 14042, Comagine Health requires its employees and contractors to be fully vaccinated against COVID-19 (including any booster shots if required), unless they are approved for a reasonable accommodation based on medical condition or religious belief that prevents them from being vaccinated. Being fully vaccinated against COVID-19 is a condition of employment at Comagine Health.

  • If you are fully vaccinated, you will be required to provide proof of your completed COVID-19 vaccination prior to the first day of your employment. Failure to provide timely proof of your COVID-19 vaccination status may result in your offer of employment being rescinded or your start being delayed.
  • If you are unable to be fully vaccinated due to medical condition or religious belief, you will be required to request an exemption upon acceptance of the offer of employment. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an exemption is not approved, then your offer of employment may be rescinded.

 

This position is located in Baltimore. View the Google Map in full screen.



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